Healthcare Provider Details

I. General information

NPI: 1588574339
Provider Name (Legal Business Name): MELISSA R GDOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 EL RANCHO RD
SIDNEY NE
69162-2420
US

IV. Provider business mailing address

PO BOX 364
SIDNEY NE
69162-0364
US

V. Phone/Fax

Practice location:
  • Phone: 308-249-9629
  • Fax:
Mailing address:
  • Phone: 308-249-9629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: